Background: High-grade gliomas (HGG) represent the commonest primary adult brain tumors. Radiotherapy plays an important role in the management of this disease.
Objectives: To assess the patterns of failure, treatment-related toxicities, progression-free survival (PFS), and overall survival (OS), following limited-margins.
Patients and Methods: In this prospective phase II study, patients with HGG have been treated with IMRT using the ESTRO-ACROP contouring guidelines that not include the peritumoral edema in the gross target volume (GTV) with adding 2cm margin around the GTV to create the clinical target volume (CTV), in one phase, after maximum safe resection of the tumor or stereotactic biopsy.
Results: The trial included 40 patients with a median age of 49 years, 16 patients (40%) were in complete remission, 13 patients (12.5%) had partial regression, and stable disease occurred in 11 patients (27.5%). The progression/failure occurred in 28 patients (70%). Failures were located infield in 24 patients (86%), out-field in two patients (7%), and were marginal in two cases (7%). No notable serious toxicities during the treatment course; the commonest toxicities were G1-2 headache and vomiting (±72.5%). After a median follows up of 12.5 months; the median PFS and OS were 11.7 and 14.3 months respectively.
Conclusion: In this study, the majority of relapses following limited volume IMRT occurred within the field of radiotherapy with acceptable treatment-related toxicity and oncological outcome, which suggest the use of IMRT with limited CTV as an acceptable treatment technique in HGG patients